Improving Access to Refractive Services in Adults: A Health Examination Center-Based Model

Purpose: To assess the potential of a health examination center-based screening model in improving service for uncorrected refractive error.Methods: Individuals aged ≥18 years undergoing the routine physical examinations at a tertiary hospital in the northeast China were invited. Presenting visual a...

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Main Authors: Haishuang Lin, Jing Sun, Nathan Congdon, Meiping Xu, Shanshan Liu, Yuanbo Liang, Hailin Wang, Shaodan Zhang
Format: Article
Language:English
Published: Frontiers Media S.A. 2021-10-01
Series:Frontiers in Medicine
Subjects:
Online Access:https://www.frontiersin.org/articles/10.3389/fmed.2021.753257/full
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author Haishuang Lin
Haishuang Lin
Haishuang Lin
Jing Sun
Nathan Congdon
Nathan Congdon
Meiping Xu
Shanshan Liu
Yuanbo Liang
Yuanbo Liang
Yuanbo Liang
Hailin Wang
Shaodan Zhang
Shaodan Zhang
Shaodan Zhang
Shaodan Zhang
author_facet Haishuang Lin
Haishuang Lin
Haishuang Lin
Jing Sun
Nathan Congdon
Nathan Congdon
Meiping Xu
Shanshan Liu
Yuanbo Liang
Yuanbo Liang
Yuanbo Liang
Hailin Wang
Shaodan Zhang
Shaodan Zhang
Shaodan Zhang
Shaodan Zhang
author_sort Haishuang Lin
collection DOAJ
description Purpose: To assess the potential of a health examination center-based screening model in improving service for uncorrected refractive error.Methods: Individuals aged ≥18 years undergoing the routine physical examinations at a tertiary hospital in the northeast China were invited. Presenting visual acuity, noncycloplegic autorefraction, noncontact tonometry, fundus photography, and slit-lamp examination were performed. Refractive error was defined as having spherical equivalent ≤ -0.75 D or ≥ +1 D and uncorrected refractive error was considered as refractive error combined with presenting visual acuity < 6/12 in the better eye. Costs for the screening were assessed.Results: A total of 5,284 participants (61 ± 14 years) were included. The overall prevalence of myopia and hyperopia was 38.7% (95% CI, 37.4–40.0%) and 23.5% (95% CI, 22.3–24.6%), respectively. The prevalence of uncorrected refractive error was 7.85% (95% CI, 7.13–8.58%). Women (p < 0.001 and p = 0.003), those with age ≥ 70 years (p < 0.001 and p = 0.003), and myopia (p < 0.001 and p < 0.001) were at higher risk of uncorrected refractive error and uncorrected refractive error-related visual impairment. Spectacle coverage rate was 70.6% (95% CI, 68.2–73.0%). The cost to identify a single case of refractive error and uncorrected refractive error was US$3.2 and US$25.2, respectively.Conclusion: The prevalence of uncorrected refractive error is high in the urban Chinese adults. Health examination center-based refractive error screening is able to provide an efficient and low-cost model to improve the refractive services in China.
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spelling doaj.art-c2ba2081a63543f18681d9579b17ddd62022-12-21T21:29:00ZengFrontiers Media S.A.Frontiers in Medicine2296-858X2021-10-01810.3389/fmed.2021.753257753257Improving Access to Refractive Services in Adults: A Health Examination Center-Based ModelHaishuang Lin0Haishuang Lin1Haishuang Lin2Jing Sun3Nathan Congdon4Nathan Congdon5Meiping Xu6Shanshan Liu7Yuanbo Liang8Yuanbo Liang9Yuanbo Liang10Hailin Wang11Shaodan Zhang12Shaodan Zhang13Shaodan Zhang14Shaodan Zhang15Department of Glaucoma, Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Zhejiang, ChinaNational Clinical Research Center for Ocular Diseases, Zhejiang, ChinaGlaucoma Research Institute of Wenzhou Medical University, Zhejiang, ChinaShenyang Key Lab of Ophthalmology, Department of Ophthalmology, The Fourth Peoples' Hospital of Shenyang, Liaoning, ChinaCentre for Public Health, Queen's University Belfast, Belfast, United KingdomZhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, ChinaDepartment of Glaucoma, Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Zhejiang, ChinaShenyang Key Lab of Ophthalmology, Department of Ophthalmology, The Fourth Peoples' Hospital of Shenyang, Liaoning, ChinaDepartment of Glaucoma, Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Zhejiang, ChinaNational Clinical Research Center for Ocular Diseases, Zhejiang, ChinaGlaucoma Research Institute of Wenzhou Medical University, Zhejiang, ChinaShenyang Key Lab of Ophthalmology, Department of Ophthalmology, The Fourth Peoples' Hospital of Shenyang, Liaoning, ChinaDepartment of Glaucoma, Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Zhejiang, ChinaNational Clinical Research Center for Ocular Diseases, Zhejiang, ChinaGlaucoma Research Institute of Wenzhou Medical University, Zhejiang, ChinaShenyang Key Lab of Ophthalmology, Department of Ophthalmology, The Fourth Peoples' Hospital of Shenyang, Liaoning, ChinaPurpose: To assess the potential of a health examination center-based screening model in improving service for uncorrected refractive error.Methods: Individuals aged ≥18 years undergoing the routine physical examinations at a tertiary hospital in the northeast China were invited. Presenting visual acuity, noncycloplegic autorefraction, noncontact tonometry, fundus photography, and slit-lamp examination were performed. Refractive error was defined as having spherical equivalent ≤ -0.75 D or ≥ +1 D and uncorrected refractive error was considered as refractive error combined with presenting visual acuity < 6/12 in the better eye. Costs for the screening were assessed.Results: A total of 5,284 participants (61 ± 14 years) were included. The overall prevalence of myopia and hyperopia was 38.7% (95% CI, 37.4–40.0%) and 23.5% (95% CI, 22.3–24.6%), respectively. The prevalence of uncorrected refractive error was 7.85% (95% CI, 7.13–8.58%). Women (p < 0.001 and p = 0.003), those with age ≥ 70 years (p < 0.001 and p = 0.003), and myopia (p < 0.001 and p < 0.001) were at higher risk of uncorrected refractive error and uncorrected refractive error-related visual impairment. Spectacle coverage rate was 70.6% (95% CI, 68.2–73.0%). The cost to identify a single case of refractive error and uncorrected refractive error was US$3.2 and US$25.2, respectively.Conclusion: The prevalence of uncorrected refractive error is high in the urban Chinese adults. Health examination center-based refractive error screening is able to provide an efficient and low-cost model to improve the refractive services in China.https://www.frontiersin.org/articles/10.3389/fmed.2021.753257/fulluncorrected refractive errorspectacle coverageopportunistic screeninghealth examination centerrefractive service
spellingShingle Haishuang Lin
Haishuang Lin
Haishuang Lin
Jing Sun
Nathan Congdon
Nathan Congdon
Meiping Xu
Shanshan Liu
Yuanbo Liang
Yuanbo Liang
Yuanbo Liang
Hailin Wang
Shaodan Zhang
Shaodan Zhang
Shaodan Zhang
Shaodan Zhang
Improving Access to Refractive Services in Adults: A Health Examination Center-Based Model
Frontiers in Medicine
uncorrected refractive error
spectacle coverage
opportunistic screening
health examination center
refractive service
title Improving Access to Refractive Services in Adults: A Health Examination Center-Based Model
title_full Improving Access to Refractive Services in Adults: A Health Examination Center-Based Model
title_fullStr Improving Access to Refractive Services in Adults: A Health Examination Center-Based Model
title_full_unstemmed Improving Access to Refractive Services in Adults: A Health Examination Center-Based Model
title_short Improving Access to Refractive Services in Adults: A Health Examination Center-Based Model
title_sort improving access to refractive services in adults a health examination center based model
topic uncorrected refractive error
spectacle coverage
opportunistic screening
health examination center
refractive service
url https://www.frontiersin.org/articles/10.3389/fmed.2021.753257/full
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